Person: KARADAĞ, BÜLENT TANER
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KARADAĞ
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BÜLENT TANER
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Publication Open Access Improvements in body mass index of children with cystic fibrosis following implementation of a standardized nutritional algorithm: A quality improvement project(2023-03-01) GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; ERGENEKON, ALMALA PINAR; YILMAZ YEĞİT, CANSU; KARADAĞ, BÜLENT TANER; GÖKDEMİR Y., ERDEM ERALP E., ERGENEKON A. P., YILMAZ YEĞİT C., Yanaz M., Mursaloglu H., Uzunoglu B., Kocamaz D., Tastan G., Filbrun A., et al.BackgroundA collaboration between the University of Michigan (UM) Cystic Fibrosis Center (CFC) and Marmara University (MU) CFC was initiated in MU through conducting Quality Improvement projects (QIP). The global aim was to improve nutritional status of children with CF (cwCF), with a specific aim to increase the mean BMI percentile (BMIp) for cwCF by 10 percentile points in 12 months. MethodsBody mass index (BMI) percentiles of cwCF were categorized as: nutritionally adequate (BMIp >= 50%); at risk (BMIp 25%-49%); urgently at risk (BMIp 10%-25%); critically at risk (BMIp < 10%). Appropriate interventions were made according to BMIp category every three months. Forced expiratory volume in one-second percent predicted (FEV1pp), and health-related quality of life (HRQoL) were evaluated. ResultsOne hundred and eight-two cwCF with a mean age of 9.1 +/- 4.3 years were included in the project. Baseline BMIp increased from 25.6 to 37.2 at the 12th month (p < 0.001). In the critically at-risk group BMIp increased from 3.6 to 20.5 (p < 0.001), in the urgently at risk group from 15.9 to 30.8 (p < 0.001), in the at risk group from 37.0 to 44.2 (p < 0.079) and in the nutritionally adequate group the increase was from 66.8 to 69.5 (p < 0.301). FEV1pp also improved significantly, from 81.3 +/- 20.6 to 85.9 +/- 20.8 (p < 0.001). Physical functioning, eating problems, and respiratory symptoms domains of the HRQoL evaluation improved (p < 0.05). ConclusionThis project has led to significant improvements in BMIp, FEV1pp and HRQoL of cwCF; similar projects could easily be implemented by centers in other developing countries.Publication Metadata only The utility of risk assessment tools for acute pulmonary embolism in children(2022-09-01) ERGENEKON, ALMALA PINAR; YILMAZ YEĞİT, CANSU; SELÇUK, MERVE; TRUE, ÖMER; ERDEM ERALP, ELA; GÖKDEMİR, YASEMİN; KARADAĞ, BÜLENT TANER; ERGENEKON A. P. , YILMAZ YEĞİT C., Cenk M., Gulieva A., Kalyoncu M., SELÇUK M., DOĞRU Ö., ERDEM ERALP E., GÖKDEMİR Y., Karakoc F., et al.Background and Aim Pulmonary embolism (PE) is a potentially life-threatening disease in children. The objective of the study is to evaluate the utility of adult-based pulmonary embolism rule-out criteria (PERC), Pediatric PE Model, and D-dimer in the diagnosis of PE in children. Material and Methods The study consisted of patients under 18 years of age who were consulted to the Pediatric Pulmonology Clinic for the evaluation of PE. Patients were divided into two groups based on the confirmation of PE. The group with the presence of PE (n = 20) consisted of children who were diagnosed with PE. The group with the absence of PE (n = 28) consisted of children with clinically suspected PE but negative diagnostic imaging. Adult validated clinical decision PERC rule and Pediatric PE Model were retrospectively applied to the patients. Results In the study, PERC demonstrated a sensitivity of 60% and a specificity of 46% for the diagnosis of PE in children. When PE Model was evaluated for the children, it was found a 50% sensitivity and 75% specificity. Combining PE Model and PERC rule with D-dimer did not increase the specificity and sensitivity. Smoking was found to be relevant for PE in the childhood. Twenty-five percent of the patients had a genetic tendency for PE. All of the patients had an underlying disease as well. Conclusion None of the current risk assessment tools (PE Model, PERC, D-dimer) were found to be accurate in predicting PE. Further larger population studies are still required to develop a better diagnostic approach.Publication Metadata only Health-related quality of life in patients with bronchiolitis obliterans(WILEY, 2020) KARADAĞ, BÜLENT TANER; Atag, Emine; Ikizoglu, Nilay Bas; Ergenekon, Pinar; Kalin, Sevinc; Unal, Fusun; Gokdemir, Yasemin; Eralp, Ela Erdem; Yalcin, Koray; Oktem, Sedat; Ersu, Refika; Karakoc, Fazilet; Karadag, BulentIntroduction Bronchiolitis obliterans (BO) is mainly caused by infections and hematopoietic stem cell transplantation (HSCT). This study aimed to investigate the health-related quality of life (HRQOL) of children with BO compared to the healthy children and also to assess the HRQOL according to the etiology. Methods Postinfectious (group 1) and post-HSCT BO (group 2) patients and healthy children were included in the study. HRQOL was assessed by the Short Form-36 (SF-36) and St George's Respiratory Questionnaire (SGRQ). Correlations between demographic and clinical characteristics, pulmonary function tests, high-resolution chest tomography scores, and HRQOL were assessed. Results Thirty-seven postinfectious and post-HSCT BO patients and 34 healthy children were included in the study. Mean age was 13.8 +/- 0.7 years. Mean forced vital capacity and forced expiratory volume(1)were 60.7 +/- 2.7% predicted, and 49.8 +/- 3.1% predicted, respectively. The SF-36 scores were lower in BO patients compared to healthy children (P < .01). Patients with better lung functions had higher SF-36 scores, but lower SGRQ. The number of inhaled therapies, acute exacerbations, hospitalizations were inversely correlated with SF-36. A positive correlation was found between these parameters and total SGRQ scores (r = .507,P = .02;r = .409,P = .12;r = .326,P = .049, respectively). SF-36 scores were better in group 1 for subscales of physical role functioning and social role functioning compared to group 2. (P = .01,P = .01, respectively). Conclusion The HRQOL of patients with BO measured by SF-36 was low compared to healthy children. SF-36 scores were more affected in post-HSCT BO patients. HRQOL of children with chronic lung disease should be taken into consideration in the management of these patients.Publication Metadata only Comparison of Conventional Pulmonary Rehabilitation and High-Frequency Chest Wall Oscillation In Primary Ciliary Dyskinesia(WILEY-BLACKWELL, 2014) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Karadag-Saygi, Evrim; Erdem, Ela; Bayindir, Ozun; Ersu, Refika; Karadag, Bulent; Sekban, Nimet; Akyuz, Gulseren; Karakoc, FaziletBackgroundEnhancement of mucociliary clearance by pulmonary rehabilitation (PR) is advocated in primary ciliary dyskinesia (PCD). Our primary aim was to compare the efficacy and safety of postural drainage, percussion and vibration [conventional PR (CPR)], and high frequency chest wall oscillation (HFCWO) by studying change in pulmonary function. Our secondary aim was to evaluate patient preferences regarding the two methods. MethodsThis was a controlled randomized crossover study. PCD patients between the ages of 7 and 18 years were assigned to two groups, first group performed airway clearance with CPR at hospital for 5 days and after a 2-day washout period HFCWO was applied to the same group at home. HFCWO was applied first to the other group and then these patients were hospitalized for CPR. The primary outcome measure of the study was pulmonary function test (PFT). The secondary outcomes were pulse arterial oxygen saturation (SpO(2)) and the perceived efficiency and comfort level. ResultsPFT values of patients increased significantly after both PR methods (before/after): CPR: FVC: 77.014.1/81.8 +/- 13.0 (P=0.002); FEV1: 72.9 +/- 14.8/78.7 +/- 13.5 (P=0.001); PEF: 73.8 +/- 14.5/82.5 +/- 14.5 (P=0.001); FEF25-75: 68.6 +/- 27.6/74.9 +/- 29.3 (P=0.007). HFCWO: FVC: 75.1 +/- 15.3/80.3 +/- 13.9 (P=0.002); FEV1: 71.4 +/- 16/77.4 +/- 14.6 (P=0.001); PEF: 70.9 +/- 18.0/78.3 +/- 17.7 (P=0.002); FEF25-75: 70.5 +/- 23.4/76.4 +/- 25.6 (P=0.006). There were no significant differences in % predicted FVC, FEV1, PEF, and FEF25-75 increased values with CPR and HFCWO. HFCWO was found more comfortable (P=0.04). Two PR methods were found efficient and no desaturation occurred during PR. ConclusionsPFTs were significantly increased after both PR methods. There were no differences in PFTs and SpO(2) between the CPR and HFCWO groups. Both PR methods were found efficient. HFCWO was found more comfortable. HFCWO may be an option in patients with chronic pulmonary disease and low adherence to PR. Pediatr Pulmonol. 2014; 49:611-616. (c) 2013 Wiley Periodicals, Inc.Publication Metadata only Effect of Night Symptoms and Disease Severity on Subjective Sleep Quality in Children With Non-Cystic-Fibrosis Bronchiectasis(WILEY, 2011) KARADAĞ, BÜLENT TANER; Erdem, Ela; Ersu, Refika; Karadag, Bulent; Karakoc, Fazilet; Gokdemir, Yasemin; Ay, Pinar; Akpinar, Ihsan Nuri; Dagli, ElifBackground: Night-time symptoms and hypoxemia during sleep may affect sleep quality in children with chronic lung disease such as bronchiectasis. Poor sleep quality may impair growth, learning, and emotional development of children. Our aim was to assess the sleep quality and associated factors in children with non-cystic fibrosis bronchiectasis. Methods: Fifty-four patients with bronchiectasis and age-matched controls were included to the study. Pittsburgh Sleep Quality Index (PSQI) and Pediatric Sleep Questionnaire (PSQ) were used to evaluate sleep quality and presence of sleep disordered breathing. A global sum of 5 or more according to PSQI indicated a poor sleep quality. A cut-off value of 0.33 in PSQ was used to identify pediatric sleep disordered breathing. Association between PSQI, pulmonary function tests, symptoms and HRCT scores were evaluated. Results: Thirty-seven percent of patients with bronchiectasis and 17% of patients in the control group had poor sleep quality (P < 0.05). Patients with sputum and wheezing had poorer sleep scores (P = 0.003 and P = 0.005). The association of wheezing and breathlessness during night time with sleep quality tended to be significant (P = 0.05). Twenty-two percent of patients with bronchiectasis and 9% of controls had sleep disordered breathing (P = 0.003). Bronchiectasis patients who snored had poorer sleep quality (P < 0.001) and patients with wheezing had significantly higher rate of snoring (P = 0.04). Children with worse HRCT scores also had worse sleep quality (r = 0.28, P = 0.04). Conclusions: Patients with bronchiectasis have disturbed sleep associated with severity of disease. Night symptoms increase the risk of poor sleep quality. Sleep disordered breathing and sleep quality should be assessed in these patients. Pediatr Pulmonol. 2011; 46:919-926. (C) 2011 Wiley-Liss, Inc.